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Organization
PERMIAN PEDIATRICS PA
Active
Organization
PERMIAN PEDIATRICS PA
Active
Other names
PERMIAN PEDIATRICS
Organization subpart
No
Provider details
NPI number
Authorized official
EDDY BELLO (PRACTICE ADMINISTRATOR)
(432) 582-2929
Entity
Organization
Contact information
Practice address
303 E 7TH ST, ODESSA, TX 79761
(432) 582-2929
Mailing address
303 E 7TH ST, ODESSA, TX 79761-4579
(432) 582-2929
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
367176001
—
TX
05
—
367176002
—
TX
Enumeration date
10/03/2016
Last updated
05/16/2018
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